The good, the bad, and the ugly: Operative staff perspectives of surgeon coping with intraoperative errors.

Background: Intraoperative errors are inevitable, and how surgeons respond impacts patient outcomes. Although previous research has queried surgeons on their responses to errors, no research to our knowledge has considered how surgeons respond to operative errors from a contemporary first-hand source: the operating room staff. This study evaluated how surgeons react to intraoperative errors and the effectiveness of employed strategies as witnessed by operating room staff.

Virtual interviews - Utilizing technological affordances as a predictor of applicant confidence.

Purpose: In the midst of a pandemic, residency interviews transitioned to a virtual format for the first time. Little is known about the effect this will have on the match process. The study aim is to evaluate resident application processes and perceived outcomes.

What predicts successful nonoperative management with botulinum toxin for anal fissure?

Background: Botulinum toxin has been established as a non-surgical alternative for chronic anal fissures. There is a paucity of data regarding which patients benefit most from this intervention.

Methods: We retrospectively collected data from all cases of chronic anal fissures treated with botulinum toxin over seven years to identify predictors of success.

Anal Intraepithelial Neoplasia and Squamous Cell Cancer of the Anus.

Anal intraepithelial neoplasia (AIN) is the premalignant condition of the anal squamous tissue. It is associated with the human papilloma virus and is considered the transition prior to the invasive anal squamous cell carcinoma. It is typically asymptomatic and can be either an incidental finding after anorectal surgery or identified when high-risk patient populations are screened.

Anastomotic leaks: technique and timing of detection.

Background: Despite the proven benefits of laparoscopic colorectal surgery, the rate of anastomotic leaks has not changed. This study looks at the time of presentation of anastomotic leaks between laparoscopic and open colectomies.

Methods: Retrospective chart review was performed between July 2008 and 2012.

Outcomes of ileocolic resection and right hemicolectomies for Crohn's patients in comparison with non-Crohn's patients and the impact of perioperative immunosuppressive therapy with biologics and steroids on inpatient complications.

Background: The purpose of this study was to compare medication use and complication rates between Crohn's disease (CD) and non-CD patients undergoing ileocolic resections and right hemicolectomies.

Methods: A review of patients who underwent ileocolic resections and right hemicolectomies from January 1, 2003, through December 31, 2010, was performed. Data collected included demographics and clinical information, biologics use (eg, infliximab, adalimumab), other medication use (eg, steroids), complications, and mortality.

Enterostomal therapy and wound care of the enterocutaneous fistula patient.

Enterocutaneous fistulas represent a challenging situation with respect to wound care and stoma therapy. An understanding of the principles of wound care and the various techniques and materials that are available is of vital importance to enhance patient comfort and recovery as well as facilitate fistula healing. Skin barriers, adhesives, dressings, pouches, and negative pressure dressings are all materials that are available in the armamentarium of the enterostomal therapist.

A comparison of laparoscopic, hand-assist and open sigmoid resection in the treatment of diverticular disease.

Background: Laparoscopic colorectal surgery (LAP) has become more prevalent as evidence of its safety and benefits become apparent. However, in difficult cases, hand-assisted instrumentation has facilitated LAP. We examined the impact of hand-assisted laparoscopic surgery (HALS) on the treatment of sigmoid diverticular disease.

Colorectal cancer screening and surveillance: current standards and future trends.

Its prevalence, long premalignant course, and favorable response to early intervention make colorectal cancer an ideal target for screening regimens. The success of these regimens depends on accurate assessment of risk factors, patient compliance with scheduled visits and tests, and physician knowledge of screening strategies. We review the current recommendations for colorectal cancer screening in general and at-risk populations, comment on surveillance methods in high-risk patients, and examine current trends that will likely influence screening regimens in the future.

Local excision of stratified T1 rectal cancer.

Background: Local excision has been accepted therapy for T1 rectal cancers. A recent study demonstrated that primary tumors with deeper submucosal invasion were associated with a higher rate of lymph node metastases than those with shallow invasion. Our aim was to determine the effect of the depth of submucosal penetration on recurrence and mortality rates following transrectal excision of T1 tumors.

The management of lower gastrointestinal hemorrhage.

Purpose: Gastrointestinal hemorrhage is a common clinical problem, which accounts for approximately 1 to 2 percent of acute hospital admissions. The colon is responsible for approximately 87 to 95 percent of all cases of lower gastrointestinal bleeding, with the remaining cases arising in the small bowel. The etiology, diagnostic evaluation, management, and treatment options available for lower gastrointestinal hemorrhage were reviewed.

Genetic testing for hereditary nonpolyposis colorectal cancer.

Approximately 80 per cent of patients with colorectal cancer have sporadic disease whereas the remaining 20 per cent seem to have a genetic component. Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common autosomal dominant hereditary syndrome predisposing to colorectal cancer. Various methods have been described to screen for HNPCC and to directly test for mismatch repair gene mutations.

A comparison of two different prophylactic dose regimens of low molecular weight heparin in bariatric surgery.

Background: Deep venous thrombosis (DVT) is a significant risk in patients undergoing surgery for morbid obesity and may be associated with significant morbidity and mortality. In a consecutive group of patients in one bariatric surgery practice, the initial group of patients who received prophylaxis for DVT was given enoxaparin 30 mg q12h while the later group was given enoxaparin 40 mg q12h.

Methods: 481 patients who underwent primary and revisional bariatric surgery over 38 months (October 1997-December 2000) were evaluated.